Dr. Dietrich Klinghardt is a physician specializing in neurological diseases such as autism and lyme, practicing out of Kirkland, Washington. Over the years, he has found that the lyme and autism patients who did not progress in their recovery many times had an underlying condition known as hemopyrrollactamuria (HPU), also known as kyptopyrroluria (KPU). HPU is a severe but reversible deficiency of zinc, biotin, manganese, vitamin B6 (or P5P), and arachidonic acid. When treated for this condition, his patients were then able to move forward in their treatment with success.

Dr. Klinghardt has found that HPU occurs in Lyme disease around 80% of the time (or more), and it occurs in over 75% of patients with heavy metal poisoning. The incidence of HPU in children with autism is over 80%.

What Is It?
HPU is an abnormality in heme synthesis. Hemoglobin is the substance the holds iron in the red blood cells. Hydroxy-hemopyrrolin-2-one (HPL) is a byproduct of hemoglobin (heme) synthesis and can be identified in the urine. HPLs bind to zinc, biotin, manganese, vitamin B6, arachidonic acid and other vitamins and minerals and lead to a significant depletion of these compounds in the brain and body.

Often such people have pale skin that easily burns, eyes that are sensitive to light, white flecks/marks on their nails, and stretch marks on their skin. They tire easily, are anemic, have poor dream recall, prefer not to eat breakfast, notice upper abdominal pain when stressed, and experience a “stitch” in their side if they run. They have a tendency to become loners as they age. Mental symptoms are aggravated when undergoing stress. In fact, pyroluria flares up when the individual is undergoing prolonged stress, such as during a chronic and debilitating illness.

Pyroluria may occur along with other imbalances as seen in some subtypes of schizophrenia such as histapenia (low histamine), histadelia (high histamine), high copper levels or cerebral allergies. It is the primary imbalance for 20% of schizophrenics.

Alcohol use is one way for pyrolurics to shut off their anxiety, feel more sociable, de-stress, and experience a short time when they feel more normal. Without a knowledge of this chemical imbalance, those who try to quit alcohol use must face coexisting with their symptoms. If additional antianxiety support is needed, GABA, tryptophan, chromium and inositol should be considered.”1

How does one get tested/diagnosed?
Scott Forsgren writes in his Public Health Alert (May 2010) article Kryptopyrroluria (aka Hemopyrrollactamuria): A Major Piece of the Puzzle in Overcoming Chronic Lyme Disease, that “HPL levels can be measured from urine through the laboratory Vitamin Diagnostics. The test costs approximately $55 dollars. A lab kit is ordered and the urine sample is returned to the lab by the patient. It is important that the patient follow the instructions as Dr. Klinghardt outlines and not the directions that come with the test kit from the lab.

Until recently, Vitamin Diagnostics offered a test for the related compound called kryptopyrrol only. Recently, they began to offer a test for the hydroxy-hemopyrrolin-2-one (HPL) compound. When filling out the requisition, the practitioner can now select HPL in addition to kryptopyrrol. The HPL test results in a much higher yield.

Dr. Klinghardt finds that in order to get the best possible insight into the patient’s condition, it is best to avoid all supplements, especially those containing zinc, biotin, and vitamin B6, for 5-7 days before the urine sample is collected. He suggests that patients use a 24-hour urine collection as opposed to first morning urine as the release of HPL complex into urine is not consistent and might be missed in a single urine collection. The sample should be shielded from light. 500mg ascorbic acid should be added to each liter of urine as a preservative.

To further maximize the benefit of testing for the condition, it is best for the patient to be under stress at the time the test is being performed as HPL excretion is known to increase during times of stress.

Dr. Klinghardt has found that Vitamin Diagnostics has the best test for HPU available in the United States. In some circumstances, however, patients may still test negative even when the condition is suspected. In those cases, an empiric trial of the HPU protocol may still be warranted.

What is the treatment?
Scott Forsgren’s comprehensive article goes on to detail the treatment that Dr. Klinghardt uses for HPU (dosages for adults):

“Before BreakfastZinc 27-40mg elemental zinc per day (as Picolinate, Gluconate or Sulfate; liquid is more effective). Initially, up to 240mg of elemental zinc may be used under the care of a doctor in those with metal toxicity and chronic infections. Nausea after zinc supplementation may be a sign of hypochlorhydria or low stomach acid. This tends to resolve after 2-4 months on the protocol.

Manganese 5mg per day (initially up to 20mg per day in those patients with joint and ligament weakness.)

Before Bedtime Vitamin B6/P5P 25mg B6 per day and 50mg P5P per day (Most patients do better with a combination of both B6 and P5P. Some require P5P. Approximately 10% do not tolerate P5P at all. Initially, up to 750mg per day may be used, especially in those with seizure disorders.)

Magnesium (Glycinate or Malate) 600-2000 mg per day – or titrate to bowel tolerance.

BioPure MicroMinerals 1 tablespoon per day

Biotin 10mg per day for brain, skin, hair, and nails

This is the core treatment for HPU.

OptionalNiacinamide 1000mg three times per day for psychiatric symptoms .

Taurine 500mg three times per day for brain-related symptoms such as seizures, brain fog, and memory loss. Supports elimination of neurotoxins, improves bile quality, increases glutathione, and normalizes brain rhythms .

Lithium Orotate or Aspartate 60mg-240mg per day

Chromium 500 mcg per day (initially up to 2 mg, especially in certain brain disorders and hypo/hyperglycemia and insulin resistance)

High Gamma Vitamin E 400 IU per 40lbs of body weight per day (Unique E is the brand often used)

HPU clients are also often deficient in silica, iodine, and boron.

In Europe, “Depyrrol” is a product which contains Zinc, Manganese, and a mix of vitamin B6 and P5P. It is used as a method of treating HPU. The more complete US product “Core” is available from BioPure Healing Products. Omega-6 oils must be supplemented in addition to Depyrrol or Core, but these products provide the patient the convenience of getting the key components of the protocol in one product. One potential consideration is that some patients may not tolerate both vitamin B6 and P5P; both of which are contained in Depyrrol and Core. As a result, it is occasionally necessary for patients to take each component of the HPU program separately.

It is critically important to monitor mineral levels during this treatment. Copper levels should be assessed using a red cell mineral test. Copper replacement is often necessary at a dose of 2-4mg per day due to the high zinc dosage. This is evaluated and introduced when necessary after the treatment has begun, often between months four and six. Zinc, manganese, and vitamin B6 are copper antagonists. Thus, monitoring levels of copper and supplementing where needed is an important part of the treatment protocol. Zinc and copper should not be taken at the same time of day.

Copper deficiency can lead to hemorrhoids, varicose veins, fatigue, edema, hair loss, anorexia, skin problems, osteoporosis, cardiovascular disease, aneurisms, and many other undesired conditions. Current nutritional teachings are misinformed on the topic of copper toxicity. The immune system uses copper and iron to fight infections associated with Lyme disease. As a result, oxidized copper is displaced in the connective tissue and may appear as though the patient is copper toxic by some testing methods when in fact copper supplementation may be appropriate. High dose Vitamin C has the effect of changing copper to a form that can be reused by the body.”2

The protocol is challenging to get through because once the mineral deficiencies are corrected, the body starts to dump heavy metals. It is critical to have a heavy metal detoxification protocol underway before this happens. For this reason and others, Dr. Klinghardt cautions that the HPU protocol should only be undertaken under the guidance of a qualified physician.

Sources for vitamins:iHerb (*Get $5 off your 1st order up to $40, $10 off $40 and over with coupon code “GEN582″ at checkout), VitaNet, VitaCost, BioPure (Dr. Klinghardt’s company)

Heather, thanks for letting me know. They must’ve changed the coding, but I’ve updated it so you should be able to watch it now. Appreciate the heads up!

Mary Smoot Souter

April 27, 2011 at 6:15 am

WOW. Where do I buy the vitamins and where do I get these urine/blood tests for HPU

much appreciated

mary smoot-souter

Shari (aka Share)

May 5, 2011 at 3:34 pm

Thank you for posting this information. I’m very interested as I have many of these symptoms. Now if I can just tolerate the protocol…..

Diane

June 18, 2011 at 9:15 am

Hi, please could you reload the video as I started watching it recently and had to stop after 45 minutes. It was very interesting and I would like to know how to get help with diagnosis and testing in London, UK. Thanks

Hi Diane,
I am not clear on what you are asking me to do. The video still works on my screen. It says it’s 2:01:32 hours long. Please refresh your browser, then click to the time when you had to stop watching and see if it will start up again from that point. Let me know! Julie

Kelly

September 19, 2011 at 7:04 pm

Have you ever noticed how Klinghardt has new discoveries and of course NEW PRODUCTS (that he manufactures) every year or so?

Now it’s HPU/KPU, and his claim that 80% of autistic patients have lyme. And of course you need his overpriced product to get well.

And EMF fields predict autism rates? O-kay.

At least he admits he has a big ego. And he admits he has failures. Perhaps that’s due to the cilantro he prescribes (which does not chelate anything), or the DMPS he used to use, which can be harmful to many folks.

And did anyone notice during the introduction he is quoted as saying (and it’s on his website) that good health depends on…”supportive network of relationships within current and PAST generations of the family.”

Look at his site to find out more about “family constellation therapy”.

I can’t believe people fall for this, fall for his charisma.

I would ask him — WHERE ARE ALL YOUR CURED, RECOVERED patients???

Karen

September 28, 2011 at 8:54 am

I could not find the HPL + kryptopyrrol test. Is it all one test?? Am I just supposed to order the krytopyrrol test?
Anyones advice please?

Kelly, I love Klinghardt but I have wondered the same thing – I have only heard of 1 person who says they are cured or immensely helped by him – the woman who was a tour manager for U2 or something like that in the Under Our Skin movie. I would love to hear from folks being helped by him, too. I am into all the far out stuff he does…but I can’t afford any of his treatments so I just get to read about it, for now. I hope people who are being helped by his protocols will post here. They are sooo complicated and involved, and dang expensive, that they are out of reach for most of us… Deep sigh.

Karen, so sorry I missed your comment! If you haven’t figured out the answer yet, I will just say that the info I shared above came from Scott Forsgren (http://betterhealthguy.com/) so you can contact him to find out the latest. What I wrote above was “Until recently, Vitamin Diagnostics offered a test for the related compound called kryptopyrrol only. Recently, they began to offer a test for the hydroxy-hemopyrrolin-2-one (HPL) compound. When filling out the requisition, the practitioner can now select HPL in addition to kryptopyrrol. The HPL test results in a much higher yield.” It sounds like you need to order BOTH. Check Scott’s site to get the latest updates on this protocol. Good luck!

I have a comment. Lyme and severe metal intolerance. If I handle tibetan silver (many times has lead, def. zinc), I am losing my bladder/kidney pain next day, perhaps 2 days next. Ridiculous.
I object to the girl above, who says “notice new discoveries…and mfr’d remedies” suspiciously. Particularly, the comment doubted, ie “autism = 80% lymies”. That man, is right on correct. I had lyme since 14 age – now almost 50 – wasnt treated till year 14. Exactly at year 14 of lyme, I was stuttering, speech delay of about 2 FULL minutes to get my mouth to say my thoughts (but zero delay to type) — and it all got much, much better with rocephin — stuttering gone, speech delay much better — not COMPLETELY lyme free yet, as 5 coinfections were overlooked and taking herbals now for (no LLMD’s where I live) — but even today, I still prefer to be silent, than to gab – talking takes a deep breath before I speak — when I anger, then the words come out…if calm, that baron’s book vocabulary vanishes and I spend 5 sentences communicating what ONE sentence should…like Peter Gabriel says, I have to stretch my mouth to let those big words come right out!…

I can DEFINITELY see, that a kid born into lyme, say from a lyme mom, by 14 (classic age) develops stuttering…and autism, that is going to be a given.

Interestingly, Gabbapentin for killer headaches — which has some constituents that are a type of nerve-receptacle blocker, makes me TALK TO BEAT A BAND…its annoying. Im just never chatty like that. Definitely, nerve damage related, all of it.

:)
PS, Good for the man, so what if he profits,? No one, and I mean NO ONE, in the U hospitals etc, is doing a darn, to cure anyone…you get a crosseyed look, a stupid routine, never heard of lyme, lyme is a myth, all the bull routine — ignoring of positive tests and suggestions to take an old-lyme name like MS or etc for what youve got (called going backwards!)….all from America’s top brains 2% who are doctors, not believable, but very lucrative.

I also see to validate the above, that YES, mega vitamin C, 5000 MG daily, makes me feel GREAT. And yes, I am anemic. The metal presence in the blood can hurt the kidneys, and cause a snowball effect of kidney damage, vit c helps this and get them back to normal. :)

Potential symptoms
“including severe inner tension, ongoing anxiety, poor stress control, fearfulness, …pale skin that easily burns, eyes that are sensitive to light, white flecks/marks on their nails, and stretch marks on their skin. They tire easily, are anemic, have poor dream recall, prefer not to eat breakfast, notice upper abdominal pain when stressed, and experience a “stitch” in their side if they run. They have a tendency to become loners as they age. Mental symptoms are aggravated when undergoing stress. In fact, pyroluria flares up when the individual is undergoing prolonged stress, such as during a chronic and debilitating illness.

BINGO!!!
Thank you so much.
I developed a rule long, long ago
he who stresses me, is outta here.
It works for me!
I live a zen life, and am comfortable this way. Anxiety, will make me puke — I do all things to have anxiety-free life…worry jobs, go the roommate. :0)

In response to Kelly, Sept 19, 2011. I am always skeptical of medical cures whether natural or evidence based, having been inside miraculous cures of medicine a long time. Klinghardt is one of the few genuine medical practitioners who knows medicine is still evolving especially lyme that can morph, be undiagnosed and ridiculously dismissed by medical doctors. I luckily had just taken a Klinghardt course when a severe case of Lyme came into my clinic. It had been Dx. ten years earlier as Lyme, and then Bartonela and treated with antibiotics. There were lession at the forhead like Leischmanias, arthralgias, urinary issues, prior uterine cancer, depression etc. We followed the Klinghardt protocol, with colon hydrotherapy and the removal of hookworms, and B6/P5P, Folic acid Methylcobalamine, herbals etc. chlorella and bee venom injections, the pain and lessions disappeared. We actually had a tick like bug crawl out of her with spirochetes daily saved along with pictures. So I do have a documented case from his protocol and she is willing to say that her life was saved because of following his advice. White Rock, BC, Canada.

Pam Klages

February 23, 2012 at 7:58 pm

Hi,
I don’t understand how your instructions say to take the zinc in the morning and the B vitamins and others at bedtime, yet both the zinc and B vitamins are both in the same supplement i.e. The Core Minerals.

Please explain, I would really like to know, do you take the zinc separate from the B vitamins or not.

Just curious about the Arachidonic acid. It says that you can get it in Ghee. I love ghee, but didn’t think there were any Omega- 6s in it. Turns out, there are, but not Arachidonic acid. If you go to NutritionData.com & look up butter oil, you can see that 20:4(n-6), which would be Arachidonic acid, shows ~, which, I guess, is negligible.

It says that coho salmon has the most at 670 mg followed by a fast food cheeseburger at 20mg. Ha. I think a burger has too many cons that outbalance the pros. Ha.

They don’t have any of the Evening Primrose, Black Currant, Borage or Pumpkin Oils in their database, which is why they don’t come up as highest.

Also, in case Kelly from September 19, 2011 is still listening, I’m always skeptical, too, especially when someone has products.

I know about Family Constellation Therapy, though, from long before I ever knew I had Lyme. Klinghardt didn’t have anything to do with the development of it, and I know of a lot of people that have been helped by it.

Also, I discovered my sensitivity to EMFs earlier this year, found a new place to live, experienced a huge reduction of autism-type symptoms & then found Dr Klinghardt after that. It my personal experience, there is something to it.

I honestly don’t think Dr Klinghardt has anything that I would call charisma, but sometimes people do have false humility. I’m always cautious when people admit that they have an ego or make mistakes, too.

I’m not ready to write Dr Klinghardt off. I was excited to find him. He seems to put a lot of things that I already knew about into one nice, neat Lyme package.

I would love to hear more from people who have worked with him, though. I think it could be of benefit to all of us.

Kelly… not everything works for everyone. And we’ve all experienced setbacks in our search. I hope you have found what works for you.

Excellent posts!! Pain in the ass to have all this stuff. Ugh. Be well all. Scott Forsgren is a very big believer in Klinghardt and has benefited greatly from his expertise. Scotts site: http://www.betterhealthguy.com

Siw Joergensen

January 21, 2013 at 8:05 pm

Where can I get tested? I live in Missouri, Kansas City. please do someone let me know.

madronewood

January 23, 2013 at 8:48 am

What does that mean, 10% of people cannot tolerate P5P? What kind of reactions do they have? It makes me nervous to try it! And I’m not finding any info on the web about it.

Jane

April 3, 2013 at 6:16 pm

Does anybody know if you have hpu/kpu does this make you have bad reactions to anti anxiety medication?

Family member has HPu/KPU and is very sens to many meds, but especially bad side effects from Benzo’s.

Thanks for any help.

Kelly

May 24, 2013 at 10:18 pm

Since no one else is saying it, I just want to warn folks against falling for Klinghardt’s constantly revised protocols. (Constantly revised, because he comes up with new products to sell — that you just have to have in order to get well, according to him). His testing method (ART) is a total sham. I know, as I was treated for 3 years by one of his associates and just got worse and worse. And no, it wasn’t a herx. It was due to the FACT that his “ART” tests are fraudulent and completely unreliable.

If anyone thinks otherwise, then I challenge them to compare his testing to standardized blood tests for the same ‘imbalance’ or missing nutrient.

David Greene

June 15, 2013 at 7:55 pm

Kelly:

May I ask what geographical are you’re in? How did you find the ART testing was off?

I’m seeing one of his disciples myself. That’s why I ask.

Kelly

July 13, 2013 at 8:48 pm

Hi David,

Sorry, just stumbled by and saw your reply. I’m in the greater Seattle area, and saw one of his close associates who used to have her practice in Bellevue, but is now located in Edmonds.

The testing was off on so many levels…don’t really know where to start. But the ART testing missed the following: SEVERE adrenal burnout which just got worse and worse, missed krebs cycle issues, mitochondrial problems, and probably the underlying problem…heavy metal toxicity, confirmed by other tests. Also, when it came to supplements, we went through at least a dozen calcium supplements, 4 or 5 tested fine, but I could not tolerate them and they made my symptoms worse. The doctor couldn’t understand it. And when it came to methylation…well, let’s just say ‘disaster’. And I’ve heard from someone who knows someone at the clinic that this same disaster happened to several other patients after I left.

The testing is a sham.

Best of luck to you!

Nik the Brick

August 5, 2013 at 7:59 am

Did anyone see Mercola walk into the cameras view? Anyway, my thoughts:
I began with high doses of Doxycyline Hyclate for 6 weeks and then added Flagyl slowly ramping up to 750mg a day. My frontal lobe nearly shut down, speech slurred, tingling hands and feet, no coordination. I went off of it all for a couple of days until these symptoms subsided some, and went back on. On and off for weeks. Then I saw Klinghardts video through the dimness of my mind, began the minerals.

The minerals zinc picolinate, Manganese, lithium asporotate, chromium, Copper, Magnesium taurate, Molybdenum are all working and each added in have made a huge difference in how I feel.

Then added B vitamins, all 50mgs some brand Solaray.
This stopped the neuropathy finally.

Japanese knotweed and artemisin, freeze dried garlic, oregano oil, ashwagandha, rhodiola, sarsaparilla, Co Q10, C, krill oil, niacin, 5-HTP.
With the Buhner herbs I have been keeping off the Flagyl and antibiotics.
As you can see, I can type and think again.
What did I find to be the most profound? The minerals. Esp the Manganese… it made a huge difference, yet after a month on the manganese phase (my experimenting before Klinghardt discovery) I became very toxic…. hmmm so much worse… my mind was ruined…. I was not detoxing.

Remember this is like art… Klinghardt thinks like a scientist always discovering new ways and is always changing. He is not the office staff and he would not be good at clerical duties. I am like this as well, and the worst at managing or herding people. I need people around me as anchors while I explore and discover. My husband is a wonderful anchor keeping my feet on the ground.
I don’t think I can do anything the same way twice because I see so many possible improvements. Kelly must be an anchor for someone else that is an explorer.

Elyse

August 10, 2013 at 12:38 am

I just have to add… I have been sick for awhile. No doctors could understand what was wrong with me. I also have anorexia. When I saw my naturopath she said I have HPU. I fit almost every single symptom! I have been on a CORE supplement regime along with adrenal cortex and it has not only helped me in recovery from my ed but almost all my symptoms are gone now!

J J Shay

February 2, 2014 at 9:05 am

I have untreated late-stage Lyme/co-infections. Can not find a good doctor. Pretty sure I have HPU. I have amalgam fillings and root canals, which I can not have removed due to cost. Also have high copper, aluminum and mercury. Can I take the Core supplement or would it be dangerous to do so with mercury filliings in one’s mouth?
Wouldn’t I have trouble, if a lot of mercury was released?

Shelley White

June 5, 2014 at 5:27 pm

I am almost positive I have this, but my blood tests came back HIGHLY toxic in b6. Could it be because it is being dumped from my tissues?

I will immediately grab your rss as I can’t in finding your e-mail subscription hyperlink or e-newsletter service.

Do you’ve any? Please let me realize in order that I could subscribe.
Thanks.

AMS

November 10, 2014 at 1:04 pm

I still would like to know why using Core will work.

Pam (above) says”

I don’t understand how your instructions say to take the zinc in the morning and the B vitamins and others at bedtime, yet both the zinc and B vitamins are both in the same supplement i.e. The Core Minerals.

Please explain, I would really like to know, do you take the zinc separate from the B vitamins or not.

Kel

January 5, 2015 at 1:54 pm

Hello,

Can someone help me?
I got HPU and i use for years depyrrol ( i come from holland) with succes. I had a multivitamin with 25mg B6, and in depyrrol 10mg B6 HCL and 50mg P5P.

I was pregnant and i get a depression so i took more B6 25mg B6 HCL in a B complex and depyrro basis i took 2 times a day. 33mg P5P and 10 mg B6 HCL.

Totall : 66 mg P5P and 70mg B6 HCL.
After my pregnancy i got Neuropathy. I know imidiatly that it was because of the B6. So i stopped with the most things but the Neuropathy didnt go away. When i took nothing from B6 or P5P then the Neuropatic pain is gone but i cant live without B6 or P5P.
I get very bad symptoms of depression en diarrhea.
What can i do? I only took 35mg P5P now but i got already neuropatic pain again. Why can i handle nomore P5P anymore? I dont know what to do.

Tomorro i will go to my doctor to see what my level of alkalische fosfatse is. How can i increase that level?

Hi Kel,
It’s just me here and I am not a physician. I don’t know the answer to your question. It sounds like you need to ask a physician, naturopath, nutritionist or other practitioner trained in vitamin toxicity/deficiency symptoms. You might try contacting Dr. James Roberts who is very knowledgeable about methylation block issues. Here is his website: http://heartfixer.com/AMRI-Nutrigenomics.htm. Best wishes, I hope you can figure out how to proceed safely. x Julie

Jack

October 25, 2015 at 5:20 am

Regarding the Klinghardt discussion, just remember:

1) One failed case doesn’t make a treatment a scam
2) One success doesn’t make a treatment a silver bullet

There seems to be no real statistics for anything in this area – so all numbers must be considered rough estimates. From seeing videos with Klinghardt I don’t think he is a scam paracctitioner. However he might be overstating some of his points. Biopure products are very expensive, but for many of them you can find cheaper alternatives.

Karla

July 13, 2016 at 9:36 pm

This blows my mind. Whets did you find the exact protocol that you followed?

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